Attachment 11

EQUAL EMPLOYMENT OPPORTUNITY STAFFING PLAN

SUBMIT WITH BID OR PROPOSAL or within a reasonable time thereafter as requested by OGS, but prior to Contract Award.

Solicitation No.: Vendor ID Number: Report includes Contractor’s

Contractor’s work force to be utilized on this contract

Contractor’s total work force

Contractor Name: FEIN:

Contractor Address:

Enter the total number of employees for each classification.

EEO Job Category Total Work Force

Work force by Gender

Work force by Race/Ethnic Identification

Total Male (M)

Total Female

(F) White

(M) (F) Black

(M) (F) Hispanic

(M) (F) Asian

(M) (F)

American Indian or

Alaskan Native (M) (F)

Veteran (M) (F)

Executive/Senior level Officials & Managers

First/Mid level officials & Managers

Professionals

Technicians

Sales Workers

Administrative Support Workers

Craft Workers

Operatives

Laborers and Helpers

Service Workers

Totals

PREPARED BY (Signature): TELEPHONE NO.: EMAIL ADDRESS: DATE:

NAME AND TITLE OF PREPARER (Print or Type):

EEO 100 (5/12)

Attachment 12

General instructions: Contact the Designated Contact(s) for the solicitation if you have any questions. All Offerors must complete an EEO Staffing Plan (EEO

100) and submit it as part of the bid or proposal package. Where the work force to be utilized in the performance of the State contract can be separated out from

the contractor’s total work force, the Offeror shall complete this form only for the anticipated work force to be utilized on the State contract. Where the work force

to be utilized in the performance of the State contract cannot be separated out from the contractor’s total work force, the Offeror shall complete this form for the

contractor’s total work force. Subcontractors awarded a subcontract over $25,000 for the construction, demolition, replacement, major repair, renovation, planning

or design of real property and improvements thereon (the "Work") except where the Work is for the beneficial use of the Contractor must complete this form upon

request of OGS.

Instructions for completing:

1. Enter the Solicitation Number that this report applies to along with the name and address of the Offeror.

2. Check off the appropriate box to indicate if the Offeror completing the report is the contractor or a subcontractor.

3. Check off the appropriate box to indicate if the work force being reported is just for the contract or the Offerors’ total work force.

4. Enter the total work force by EEO job category.

5. Break down the total work force by gender and enter under the heading “Work force by Gender.”

6. Break down the total work force by race/ethnic background and enter under the heading “Work force by Race/Ethnic Identification.” Enter the name, title,

phone number and email address for the person completing the form. Sign and date the form in the designated boxes.

RACE/ETHNIC IDENTIFICATION

Race/ethnic designations as used by the Equal Employment Opportunity Commission do not denote scientific definitions of anthropological origins. For the

purposes of this report, an employee may be included in the group to which he or she appears to belong, identifies with, or is regarded in the community as

belonging. However, no person should be counted in more than one race/ethnic group. The race/ethnic categories for this survey are:

WHITE - (Not of Hispanic origin) All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.

BLACK - A person, not of Hispanic origin, who has origins in any of the black racial groups of the original peoples of Africa.

HISPANIC - A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.

ASIAN & PACIFIC - A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent or the Pacific Islands.

ISLANDER

AMERICAN INDIAN - A person having origins in any of the original peoples of North America, and who maintains cultural identification through tribal

OR ALASKAN affiliation or community recognition.

NATIVE (Not of Hispanic Origin)